Provider Demographics
NPI:1093837577
Name:SERAYDARIAN, DON G (PHD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:G
Last Name:SERAYDARIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1009
Mailing Address - Country:US
Mailing Address - Phone:215-860-0848
Mailing Address - Fax:215-860-1244
Practice Address - Street 1:1705 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1009
Practice Address - Country:US
Practice Address - Phone:215-860-0848
Practice Address - Fax:215-860-1244
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003336-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist